Editor’s note: Kent Campbell is the director of PATH’s Malaria Control Program, and was recently awarded the American Society of Tropical Medicine and Hygiene’s LePrince Medal. The views expressed are his own.

When I began working on malaria in the late 1970s, the disease was rampant. Working for the U.S. Centers for Disease Control and Prevention, I was stationed at a hospital in the Western Kenya district of Siaya. In the pediatric ward there were often two children to a bed, with more than half succumbing to malaria-related anemia.

Kenya didn’t have a strategy to protect children from malaria – at that time no African country did. In fact, bed nets, a cornerstone of today’s prevention efforts, were not being used. They hadn’t yet been proven to be an effective tool for fighting malaria. Instead, the focus was on providing treatment for the sick and trying to delay death that was often unavoidable.

Malaria was, without a doubt, the biggest problem Africa faced; but it was largely invisible. It was not considered a national or global priority and international funding was virtually nonexistent. We didn’t have the knowledge or tools to get it under control and make a lasting impact.

This all began to change, just over a decade ago. Data demonstrating the incredible power of bed nets began to mount and we realized the benefits of combining tools and strategies under national programs to control malaria. Until this point there wasn’t a roadmap to guide countries, showing how to do it and what to expect.

Beginning in 2005, we had the opportunity to do just that, show how you could design and implement a national malaria control program and make an impact. In partnership with the Zambian government, the Scale-up for Impact (SUFI) approach was implemented to rapidly deploy, at high coverage levels, malaria prevention tools to achieve maximum health impact. Zambia became the first country in Africa to successfully achieve high coverage with tools like bed nets, and the results were nothing short of dramatic. From 2006 to 2008, malaria cases, hospitalizations, and prevalence in children were reduced by more than 50 percent in Zambia – a major drop in a short period of time, never before seen in Africa.

The SUFI approach is now the global standard for malaria control, and has been implemented in more than 40 African countries. Thanks to these efforts and the work of national programs across Africa, partners like the World Bank and the U.S. president’s Malaria Initiative – and a surge in international funding through organizations like the Global Fund – the lives of more than one million African children have been saved in the last ten years.

Today, many of the countries that were early adopters of SUFI are now setting their sights on eliminating malaria, a once unfathomable goal. Kenya is one of these countries. The pressures and demands malaria put on the country’s health services have been relieved.

We know malaria can be controlled. We’ve seen the results. Lives saved. Health improved. But controlling malaria isn’t an acceptable goal, and especially not when we see a very real path toward elimination for the first time. It’s time to end one of the leading threats to Africa’s children by eliminating malaria. The evidence we’re seeing across Africa shows this is possible. What’s needed now is a new road map to guide countries on the path toward elimination. And our group at PATH, along with national program partners, is working on the development of the practical experience at the program level to build such a road map.

We’re working with partners across Africa, like Zambia, to show what works and what’s needed and to plot the path ahead. By maintaining the use of proven prevention tools while aggressively diagnosing and treating malaria, we can break the chain of transmission and end infections in Africa. We’ll create malaria-free zones one at a time, and grow them – to districts, states, and countries. The fight will be long, but it’s one that we can win.

But to say that malaria can be eliminated in Africa does not mean that it will be eliminated. Success requires political and financial support. It’s an effort that will require all of us – local and national governments, the global health and donor community, scientists and policymakers. We know there are challenges ahead, with countries and partners facing competing priorities and financial pressures, but we also know this is a fight that’s worth it. Together, we can make malaria history.

Malaria was conquered until Rachael Carson's junk science book, Silent Spring, caused the US to go on an international crusade to ban DDT. Anyone who has bothered to do the research now knows that Carson was totally wrong and that spraying with DDT is the best way to eliminate malaria – that was proven in the 1950s when the disease was largely eliminated.

Unfortunately, political correctness does not permit us to recognize that an environmental icon was dead wrong. Thousands upon thousands have died in tribute to Rachael Carson; it is now time for that to end.

DDT was fantastic against both malaria and other parasite-born diseases such as leishmania. However, thanks to over-use of DDT by farmers and incomplete coverage by some countries, many carrier species are now resistent to DDT. Bringing it back at this point probably wouldn't have the same dramatic effects that it did the first time around.

DDT has been used in Africa for years; it is still available as a malarial remedy there, and has never been off the market. The problem is that mosquitoes and other insects have become resistant to it. Added to its broad-spectrum, non-selective nature, it is simply not an effective tool against malaria.

Malaria was once endemic in the United States, even in places like Michigan and Illinois. It was controlled, long before pesticides were available, through environmental modification – to be brief, draining the swamps. In Africa, the reverse has occurred; deforestation has opened up large, soggy areas to abundant sunlight, the habitat preferred by the mosquitoes that carry malaria. As their habitat has been expanded, not surprisingly so has the disease. Nonetheless, environmental controls are the ultimate, long-term solution to the problem, with selective pesticides used sparingly and in limited areas.

This is AFRICA'S problem. So the U.S. and western world should first save everyone from malaria, then feed the people who will reproduce at rates UNSUSTAINABLE to the place they live in. Then we will get bombarded with commercial after commercial of sick starving african babies that we are supposed to save.

November 27, 2012 at 11:18 am |

colin in Florida

Unfortunately, you are wrong. DDT is known to cause disastrous decreases in bird populations because of thin shells, many of them birds that eat mosquitos. In addition, many mosquito populations are now resistant to DDT, so even if used again (and it was never banned in many places) today it has little impact.

DDT causes problems when misused just like anything else when misused.
It is by far the best insecticide for combating malaria because it can be safely used where humans live; even in their hair and clothing. No other insecticide can be used in this fashion without injuring the humans being protected.

The ban on DDT costs many hundreds of thousands of lives per year, but those who die tend to be poor brown and black people who are not valued as much as the rich environmentalists who brought on the ban.

Nice story, but it's a fairy tale. Although DDT was eventually banned worldwide in the mid-1970s, that ban was only for agricultural use; it's use for control of disease was never banned, and it is still used today for such purposes. Like all insecticides, however, mosquitoes have largely developed immunity to it, and its effectiveness is now very limited.

November 26, 2012 at 7:39 am |

John K. Lim MD

What is Rachel Carson's responsibility in the resurgence of Malaria and the millions of suffering and death in the African Continent? To who does she answer to for the sequelae of her Politically Correct push without science behind it? Her activity and the resultant deaths is worse than the murders by Hitler, Mao combined. How is she being made to answer for her actions? Damn it to hell for all the do-gooders without any scientific basis. A lawsuit and compensation of infinite amount should be brought against her and her foundation and organizations that are responsible for this holocaust

You have to imagine that most women neither have access to nor can afford birth control like those in the West. Religions like Catholocism and FLDS take away reproductive rights from women. It will be interesting to see what effect the mandated free contraception under Obamacare will have on abortion rates and unintended pregnancy particularly for low income women.

Why do the macho men impregnate women. Cuz they feel the urge to. Same thing goes on in all western cities and quiet lil towns, so don't go blaming women. What happens when the woman doesn't feel like putting out, men get all macho, quote Allah or some celebrity.

One company that is helping end malaria is Mombasa Brand out of Arlington, Texas. With each decorative bed canopy purchased on their website at http://www.giveanet.com, they will donate one mosquito net in the effort to end malaria.

We have been attempting to eleminate polio for decades, with 99.9% success, but still it hangs on in some countries. Here, we can kill the disease by breaking the carrier chain. How will we ever eleminate all the malaria-bearing mosquitoes?

Mosquito biology is closely tied to temperature. So in a warming planet, getting rid of malaria will be an uphill battle.

Although malaria has been eliminated in the United States since the 1950s, the mosquito vectors are still
on the loose - alive and well and breeding in great numbers. This puts the country and other similar
regions in the world where malaria have been eliminated at a constant risk of re-introduction of the disease.

To turn the tide of war against malaria, responsible use of DDT should be on the table, in addition to other measures to combat the parasite and its mosquito vector. There has to be a balance between environmental protection and saving human lives.

Responsible use of DDT to combat malaria IS on the table, and has never been taken off the table. The worldwide ban on DDT that took effect in the mid-1970s was for agricultural use only – use for disease control has never been banned, and DDT has continued to be used in that role. It is largely ineffective nowadays because mosquitoes have developed resistance.

The same unintended consequences that environmental activists complain about on any endeavor apply to activists as well, whether informed, ignorant as stones, or pursuing a religious cause like climate change. Sadly these folks are never accountable for their actions which rarely achieve results that are positive for people, regardless of what their belief systems tell them.
If an environmental impact statement were required before the implementation of mosquito netting, the netting would probably be banned because it deprives a natural preditor of an important food source. Suppliers of netting would be required to improve mosquito habitat by daming up drainage or digging shallow wetlands to improve mosquito breeding grounds.

Having had palasidium vivax (5 times) and falcium (1 time) doesn't make me an expert but a survivor. It took 3 weeks of treatment to finally cure the falcium (which is immune to most treatments.) The reason it is immune is because the natives don't complete the medical treatment and thus you get malaria which is more immune than previously known. Halfan (French Cure) and Artensunate (Chinese herb) were the best treatment when I was there in W. Africa. We had a spraying program with malathion and diesel but the govenment would shut it down for a week so the mosquito counters could go out, let the mosquitoes bit them and estimate how many bites they had gotten thus to get account of the effectiveness of the spraying program.

The point given in the article about early dismissal of nets was because the drug companies were making money by selling the treatment medicines. The drug companies campaigned against nets because the nets cut into their profits. The same is true for the corporation(s) that make DDT. Corporations can't make money if we think outside the box. The KISS method of thinking and common sense tells you that keeping people away from the mosquitoes by using nets will through attrition end malaria.

Uh, no. It was simply that nets hadn't been proven to have any beneficial effect at the time. It's easy to count mosquito populations before and after spraying; measuring the effect of nets takes considerably longer, just because of the nature of their operation. I know it's comforting to think you've concocted some evil cabal that can be blamed for one of the world's ills, but the humdrum truth is that we don't have perfect knowledge, all at once, available at all times.

I'm sure you can find some websites – probably right next to the ones promoting chemtrails and the machinations of the Bilderbergers – that will happily swallow the bilge you are peddling, and probably even more that are already puking it out. You can take some comfort in that, in the utter absence of actual fact or proof of your rant.

.
Malaria is of scant importance - compared to deliberately imposed ignorance and deliberately imposed inability to fully and constructively use one's brain.
.
Religion and Extremist Politics are one of the most effective tools available for the above-mentioned negative purposes.

You believe that humans are naturally smart but kept from using their wits in the wild thanks to oil companies and big pharma. History paints a different picture. Its survival of the fittest, not merely strongest or smartest, and therefore countless thousands are doomed from the beginning. Natural selection, etc

I don't understand how people wouldn't conclude that nets are helpful. Malaria is spread via mosquito bite, so keeping the mosquitoes away is the first step. A simple cheap tool to use in a warm climate is a net around the bed at night, when the critters come out.

Anemia is the most common disorder of the blood. The several kinds of anemia are produced by a variety of underlying causes. It can be classified in a variety of ways, based on the morphology of RBCs, underlying etiologic mechanisms, and discernible clinical spectra, to mention a few. The three main classes include excessive blood loss (acutely such as a hemorrhage or chronically through low-volume loss), excessive blood cell destruction (hemolysis) or deficient red blood cell production (ineffective hematopoiesis).;'.^

Post a comment

CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About us

The Global Public Square is where you can make sense of the world every day with insights and explanations from CNN's Fareed Zakaria, leading journalists at CNN, and other international thinkers. Join GPS editor Jason Miks and get informed about global issues, exposed to unique stories, and engaged with diverse and original perspectives.